Sustainable peritoneal dialysis: Your questions answered

As humanity's marked effects on Earth's natural systems become increasingly apparent, we witness with alarm the impact on health and healthcare delivery. In this review, interrelationships between climate change, kidney health, and peritoneal dialysis (PD) therapies are described, and expansion of duty of care to the environment while maintaining the highest-quality healthcare is explored. Practical, high-yield actions that can be undertaken by patients and providers through the principles of sustainable care are introduced, including medication and single-use plastic consumables optimization, incremental PD, remote health monitoring, innovative PD effluent drainage, waste optimization, and importantly, patient empowerment as partners in sustainability. To ensure sustainable practices are embedded in clinical care, creation of a network of green champions, alignment with low carbon sustainable health systems more broadly, and appropriate uptake of emerging innovations in PD therapy that may be offered through sustainable procurement and regional or point of care dialysate production are crucial.